Mario Skobic, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

42199 Issued in WI

Practice address

37100 N Gantzel Rd Ste 201
San Tan Valley, AZ 85140-7352

Phone

(480) 394-4520

Fax

(480) 394-4469

NPI assigned

Nov 15, 2005

Last updated

Jul 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1609858851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WEST AVE SOUTH",
            "city": "LACROSSE",
            "state": "WI",
            "postal_code": "54601",
            "telephone_number": "608-791-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37100 N GANTZEL RD STE 201",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407352",
            "telephone_number": "480-394-4520",
            "fax_number": "480-394-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOBIC",
        "first_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "42199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Shockley, PT, DPT
• Leann Silva
• Mark Simmons
• Abhilasha Singh, MD
• Kenneth Lee Sisco, M.D.
• Skybridge Harmony Homes
• Skyline Ja LLC
• Andrew Michael Smith, M.D
• Michelle Smith, NP
• Xavier Smith, CPT, CHC, CLC

• Internal Medicine Physician in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.